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Renal Failure Feb 2015To assess the effects and safety of iron-based phosphate binders in adult patients receiving dialysis. (Review)
Review
AIM
To assess the effects and safety of iron-based phosphate binders in adult patients receiving dialysis.
METHODS
We electronically searched MEDLINE, EMBASE, CENTRAL, and CBM for randomized controlled trials about iron-based phosphate binders in adult dialysis patients. Study quality was assessed using the criteria outlined in the Cochrane Handbook for Systematic Reviews of intervention. Meta-analysis was conducted by RevMan 5.3.
RESULTS
Eight studies with 2018 participants were eligible for our meta-analysis. Iron-based phosphate binders were superior to placebo (MD = -2.43 mg/dL, 95% CI: -3.18 to -1.68, p < 0.00001) and as efficient as sevelamer (MD = 0.04 mg/dL, 95% CI: -0.29 to 0.36, p = 0.83) in reducing serum phosphorus in dialysis patients. No significant differences were found in all adverse events (OR = 1.30, 95% CI: 0.77 to 2.20, p = 0.32) between iron-based phosphate binders and placebo. Iron-based phosphate binders were associated with significant higher serum iron (MD = 9.39 ng/mL, 95% CI 1.48 to 17.30, p = 0.02), higher serum transferring saturation (MD = 6.29%, 95% CI 2.72 to 9.87, p = 0.0006) and lower serum total iron binding capacity (MD = -23.13 µg/dL, 95% CI -35.69 to -10.58, p = 0.0003) in comparison to placebo.
CONCLUSION
Iron-based phosphate binders are as effective as sevelamer and well tolerated for hyperphosphatemia in dialysis patients. Iron-based phosphate binders appear to have a beneficial effect on renal anemia in patients receiving dialysis. Therefore, iron-based phosphate binders may represent a new treatment option for dialysis patients.
Topics: Humans; Hyperphosphatemia; Iron; Phosphates; Polyamines; Randomized Controlled Trials as Topic; Renal Dialysis; Sequestering Agents; Sevelamer
PubMed: 25350834
DOI: 10.3109/0886022X.2014.976160 -
Journal of Renal Nutrition : the... Nov 2014Metabolic bone disease (MBD) is a common complication of chronic kidney disease (CKD). The currently accepted international guidelines for treatment of CKD-MBD has been... (Meta-Analysis)
Meta-Analysis Review
Metabolic bone disease (MBD) is a common complication of chronic kidney disease (CKD). The currently accepted international guidelines for treatment of CKD-MBD has been published, unfortunately adequate control of serum markers of disorder, especially hyperphosphatemia, is poorly achieved. Whether educational intervention is an effective way for improving CKD-MBD remains controversial. A systematic review of educational intervention versus routine care to improve patients with CKD-MBD was conducted. All randomized controlled trials (RCTs) and quasi-RCTs examining the efficacy of educational intervention to improve patients with CKD-MBD were included. We performed a comprehensive search of several databases and sources to identify eligible trials. In addition, we searched unpublished studies by tracking the SIGLE (System for Information on Grey Literature) database. Finally, 8 RCTs and 2 quasi-RCTs containing 775 participants were included in our systematic review. The result of our study revealed that the educational intervention to patients with CKD-MBD led to an improvement of the serum phosphorus and calcium by phosphate product. Educational intervention is a beneficial supplement method in improving CKD-MBD and putting off deterioration of the disease.
Topics: Biomarkers; Bone Diseases, Metabolic; Calcium; Databases, Factual; Health Knowledge, Attitudes, Practice; Humans; Hyperphosphatemia; Patient Education as Topic; Phosphorus; Randomized Controlled Trials as Topic; Renal Insufficiency, Chronic; Treatment Outcome
PubMed: 25193107
DOI: 10.1053/j.jrn.2014.06.007